Sclerotherapy Vein Treatment FAQs Sclerotherapy Cost and Vein Treatment in St Louis

I would like to become pregnant, but would like to know what’s safe.

I am asked this question many times. You can safely get pregnant immediately after a Sclerotherapy vein treatment. But if you do get pregnant in the middle of a series of treatments, you should stop all treatments until 3 months after you deliver. This is a wide safety margin for the prevention of blood clots. The medications that are used by almost all experts, Sodium Tetradecyl Sulfate and Polidocanol, are very safe. They are fatty acid esters similar to lidocaine. They are cleared out of your system in 24 hours or less and present no difficulties.

I have spider veins on my cheeks and the backs of my hands. The thought of sclerotherapy on my face scares me, but I heard IPL can treat spider veins too. Is this true? How does it remove the veins? 

On the face, IPL can treat spider veins. The Intense Pulsed Light (IPL) actually targets the hemoglobin that is found in the red blood cell as it crosses the veins. The light is absorbed by this compound which then is converted to heat. The heat actually shrinks the capillaries. The overall treatment is quite effective and safe. Multiple treatments are required.

Yes. Sclerotherapy, which is an injection of a medication to close veins, can help or relieve symptoms such as tenderness, aching, and burning caused by varicose veins. However, it is best to have an evaluation by a doctor with an ultrasound to know the full extent of your vein problems before starting sclerotherapy for symptomatic veins. The evaluation is important! If you have symptoms associated with your varicose or spider veins. You may have reflux in your saphenous vein which should be treated before you have sclerotherapy.

My friend had sclerotherapy a few days ago, and now she has blisters around the area that was treated. Is this a normal side effect? She said her specialist never mentioned anything about possible blisters.

Your friend may be experiencing skin breakdown which can happen with any sclerotherapy. It will heal fully but it must be treated properly. I would contact the doctor right away to let them know.

Foam sclerotherapy refers to mixing a sclerosant medication with a gas to make bubbles and injecting into veins. Most often air is used. CO2, carbon dioxide, can also be used. CO2 is rapidly absorbed into the tissues. Theoretically, CO2 gas might be safer. On a clinical level, there is no proof that using CO2 make foam sclerotherapy any safer or better.

Yes, you can have sclerotherapy on your hand and wrist. I don’t advise getting sclerotherapy on your arms as you may need those veins for IV or blood draws.

How long should I refrain from the hot tub and pool? 

We recommend a week of avoiding hot tubs or Jacuzzi after sclerotherapy. The reason is based on a study that showed better cosmetic results after sclerotherapy for patients who wore compression stockings. Bathing in hot water has the opposite effect of compression, so we ask for patients to refrain from it and wear stockings for a week.

It is variable. Most patients will see the veins looking much worse for the first 2 weeks. After that, they see some improvement. Some patients can enjoy great results as soon as 4 weeks after injections, others might take up to 3-4 months. Things usually look worse for a month or so then fading starts, and it can take several months before significant improvement is noted. It also usually takes more than one treatment.

Although sclerotherapy may be performed by any type of physician, you will likely experience the best results with someone who is both highly experienced and a specialist in treating venous disease, and in the use of sclerotherapy specifically. Look for someone who is a vein specialist, with years of experience, board certified in phlebology, vascular surgery, or vascular medicine, and one whose practice is devoted to treating veins, as well as one who has multiple treatment options available depending on the patient’s underlying issues.

I had sclerotherapy yesterday, but I can still see a few of the veins that were treated. How long until all the veins disappear?

It is quite variable from patient to patient and from vein to vein. Most of the time it takes at least 3-4 weeks before some results can be appreciated, however could go as long as 3 months before improvement can be noticeable. Some go away right away, while some look worse and slowly fade. It rarely is done in one treatment.

Polidocanol is a sclerosing agent, a drug used to treat veins. It works quite well. Currently, it is available only from compounding pharmacies in the US, although it will be available from a manufacturer soon. The drug most commonly used in the US is Sotradecol, which works well also. This is the FDA-approved drug available here. All of these drugs work by injuring the vein wall causing the vein to scar down and close off, thereby removing the varicose/spider veins.

I use compression hose for three days to three weeks and tell patients it is fine to shower without them on. So for my patients they can shower the day after sclerotherapy. This will depend upon the treating physician. It may depend on what type of bandages your doctor prescribed. Typically, any post-procedure dressing is removed the following morning, and patients may take their first shower at that time. You should contact your vein doctor and have them review their specific post-instructions with you. But I don’t use bandage, and only use compression stockings.

I’ve heard that birth control pills can have an effect on the vein walls, softening them and causing problems. Is this true? Could being on the pill then create problems with sclerotherapy? 

There is not strong data suggesting that BCP’s effect the results of sclerotherapy. The major concerns would be a possible increased incidence of DVT and increased blushing or matting, but no data to date has shown this.

I heard that Asclera (Polidocanol) was recently FDA approved. When can patients expect this sclerant to be widely available in the US?

It was approved and is now available.

I haven’t had it evaluated by a doctor, but I do bruise extremely easily and the bruise usually stays for at least three weeks, even for a minor bump. Is this something I should have checked before undergoing sclerotherapy?

Sclerotherapy is generally safe for the vast majority of patients, even for those who may bruise easily. Obviously, there are multiple injections performed with treatment, so bruising is not at all uncommon, and may last for variable amounts of time afterward. However, in your specific case, if you bruise with even minor trauma, and it lasts for an extended period of time, you may want to have your physician evaluate you for any potential bleeding disorders, just to make sure there is not something significant going on.

While sclerotherapy may work well for small veins, a new device called VeinWave may be a better choice. VeinWave uses a tiny needle tip to deliver heat to the vein and works very well for many small facial veins with much less pain and discoloration than sclerotherapy. Another option is IPL (Intense Pulsed Light) which can be painful, more expensive and takes several treatments but is able to treat other skin changes as well as the veins.

Difficult to tell if related. Nerve damage can develop after stripping or EVLT. Usually this results in pain and numbness around ankle and inner forefoot. It should improve with time, but can take up to a year to resolve. I am unaware of this problem with sclerotherapy. Unless a direct injury to nerve with the needle occurred.

I have large, purple veins on the underside of my wrists that I’d really like to get rid of because they really show my age. Is there a safe way to do this?

Sclerotherapy can be used to eliminate hand and wrist veins safely, however the real question is whether is it a wise and safe goal to do so. As you indicate, you feel that these veins are signs of your age. Almost certainly, these veins are normal and may become more visible due to the reduction of the normal fatty layer which accompanies aging. Normal veins on the wrist are considered valuable for blood draws and IV access among healthcare professionals. There are so many reasons to save normal veins for medication treatments, potential dialysis, trauma, that most vascular surgeons may be reluctant to destroy them.

It has been 8 weeks since I had spider and 1 surface blue vein injected by a vein surgeon. I still have black and blue spots and the surface vein looks worse, will this correct itself or do I need more treatments/new doc? 

Post-sclerotherapy bruising is normal, however should be expected to resolve by 2-3 weeks. Discoloration persisting beyond this period is most likely not bruising. Bruising can be easily confused with either or both hyper-pigmentation and trapped fluid within the veins. In both of these instances, the veins ALWAYS look worse and more prominent than pre-treatment. Trapped fluid within a treated vein can occur due to inadequate compression, walking, or failure to identify and treat those blue veins which flow into the spider veins. Also, a combination of the above can exist. Depending on the cause, blue “feeder” veins need to be treated with sclerotherapy. In any case, the trapped fluid should improve after the veins are aspirated and fluid is expressed. Hyperpigmentation can occur secondary to trapped fluid. It can also occur depending on several factors including skin characteristics, concentration of sclerosant solution, and technique. The pigmentation will usually fade, although slowly, continuing for up to, but not necessarily requiring, two years.

If the chemical is injected directly into the vein and stops in up, couldn’t the blood clot and cause problems? Is sclerotherapy safe if someone has blood clotting disorder?

The intention of sclerotherapy is to create inflammation within the lining of the vein, causing it to collapse and seal close. This process frequently involves trapping and subsequent clotting of small amounts of blood within the involved vessel, which the body slowly re-absorbs over time. This process is perfectly normal, and is not dangerous. The dangerous types of blood clots are called “deep vein clots.” These vessels are all superficial and very small. I have not experienced difficulties with patients who have clotting disorders, again because the treated areas are very superficial, and involve small vessels. However, common sense would dictate that we would simply exercise more caution, and be more conservative with someone who has a known clotting disorder, depending on what type it is.

Is there an upper age limit with ELA? My mother is 82, and she has varicose veins that have gotten progressively worse in the past 2 years. She complains that they are painful and make her legs feel heavy. She’s in good health and active, but is there an upper age limit with ELA?

No, there is no age limit. In general, like all elective procedures your mother’s general health should be taken into consideration when deciding whether to have the procedure. ELA, Endovenous Laser Ablation, is a pretty low risk procedure so if your mother is healthy, there is no reason not to have her varicose veins treated.

This depends on the amount and strength of solution used, the types of veins being treated, your skin type, your genetic propensity to develop hyperpigmentation. You get the drift. It is different for everyone. The rule of thumb is about 6 weeks between large treatments and it could take many months before any pigment changes clear and everything fully heals.

Sclerotherapy is treatment with a chemical sclerant, which irritates a vessel’s lining, making it become inflamed, harden, and eventually fade away completely. This treatment is used for the removal of spider veins and smaller varicose veins.

Some minor itching and burning immediately after treatment is normal. Hyperpigmentation occurs in about 2-8% of treatment. This usually resolves in time. Matting of veins in a reddish area can occur, which will require additional treatment, but usually goes away. Rarely, infection and skin breakdown can occur. These also resolve in time, though skin breakdown may result in some scarring. In very rare cases, allergic reactions are possible.

No, because large veins require more sclerosant injected than is safe. This treatment is not appropriate.

Whether you have had sclerotherapy or endovenous laser ablation (EVLT), you should not participate in any strenuous activity for the initial days that follow, but it is important to walk regularly to encourage good circulation.

I’m considering sclerotherapy, but want to know if patients typically need more than one treatment to get rid of all of the spider veins in an area.

Yes, it’s very common. It usually takes several treatments. Each treatment session should be separated by at least 4 weeks. If you have more that very few veins in a small area, it usually takes 2 or three treatments and will often require “touch ups ” in a year or two.

I am taking a number of medications for high blood pressure and was wondering if it is safe to have sclerotherapy or if another treatment would be better.

Sclerotherapy solutions in general are very safe. They have very limited side effects and risks. There are typically no big concerns with solutions and most daily medications including high blood pressure medications. Minocycline (an antibiotic) should be avoided due to increased risk of pigmentation problems and if you are on blood thinner you should consult with the doctor performing the sclerotherapy and discuss the reason for the blood thinners. The judgment to use a sclerossant should be made by your vein specialist on an individual basis.

Unlike certain light based treatments that should be avoided while on Accutane, Sclerotherapy treatment can be done. There are no warnings about interactions of the medication used in sclerotherapy and Accutane.

Everyone with unsightly spider veins is eligible for treatment unless the individual has one of the following: -they are pregnant or breastfeeding-has a skin infection-uncontrolled diabetes-history of deep vein thrombosis

Each session on average takes only 15 to 30 minutes to complete, though it can vary depending on the size and extent of the treated area.

Foam sclerotherapy is typically used for larger veins that are not visible on the skin surface and therefore the answer is yes, ultrasound is necessary. The tiny superficial veins that are treated with sclerotherapy do not require “foaming.” Making a sclerosant foamed causes it to be stronger. Some physicians like to treat the veins known as reticular veins with foam. These are the visible veins that are larger than spider veins but smaller than varicose veins. They “feed” the spider veins. In this circumstance, ultrasound would not be necessary.

While some physicians may use foamed solution to treat smaller veins, typically the spider veins and pale green reticular veins are treated without foaming the solution being used. In my practice we use a weak sclerosant that works nicely will little discomfort. It is not foamed. When treating large bulges and varicose veins, foamed solution is necessary.

Does the foam sclerotherapy procedure hurt more due to the foam expanding in the vein?
A small needle is used so there is very little pain – the foam itself does not hurt during injection.

I’ve heard that drinking can dilate blood vessels. Will drinking affect my sclerotherapy procedure? Should I stay away from alcohol for a certain amount of time? I normally have 1 or 2 drinks 3 or 4 times per week.

The vasodilatory effect of alcohol only last for a few hours, less than four to be exact. So, it should not matter if you drank alcohol the night before unless you had quite a few drinks. Depending on your size and sex it would be at least 4 to 6 drinks, which is more than you drink in a week. In summary, the moderate drinking you describe should not have any effect on your sclerotherapy results.

Does this procedure require an MD or can an aesthetician or cosmetologist be trained in this procedure? Are there regional issues. Can this procedure be done by an aesthetician is some states rather than others, for instance?

It is a medical procedure so it must be done by a doctor or under the supervision of a doctor. In some states aestheticians or cosmetologists can be supervised by doctors, and they could be trained to perform the procedure. You should check with the state medical boards.

How long does the Sclerosing agent remain in bloodstream after a procedure? I had it done while breastfeeding and was told to just disregard and continue.

Sclerotherapy solutions are safe in general. Saline solutions pose no risk to a breastfeeding infant. STS and other sclerosants, if used, are cleared fairly quickly. Usually within a few hours. There are no standards established regarding breastfeeding and sclerotherapy. But because it is cleared quickly, I recommend to nursing mothers that they pump the next 2 times their child would feed and discard the milk. They would supplement during this time of course. Then they may resume breastfeeding.

Essentially “YES,” it is the same principle and even the same equipment. It requires special software and a different probe than the one used in Obstetrics to be vein-specific.

Sclerotherapy can cause blood clots with an open vessel which theoretically could present a concern. In practice however this is extremely rare. These type of “blood clots” are termed “Thrombus”, which is a clot within an open blood vessel. The lumps that you are referring to is clotted blood in a treated vein which by the treatment has been eliminated from the circulation. These types of clots are termed “Hematomas” which have essentially no health threat because they are trapped in the tissue and cannot travel. Typically, these should be drained for purposes of comfort as well as appearance.

Sclerotherapy remains the gold standard of treatment for spider veins. No, each vein does not have to be injected. You should be seen by an experienced vein center who can discuss with you the various options, and what works best. Sclerotherapy is the most effective treatment for almost all of the veins you can see on your legs, from the bigger ropey veins to tiny purple veins that seem stuck on the top of the skin. Sometimes the very smallest spider veins that look like fine red threads stuck on the leg can be treated by the veinwave or light therapy treatments..

Usually, multiple treatments are required initially. Usually 2 or 3 treatments are done at first. New veins frequently grow into the treated area, so periodic touch-ups are usually required to keep one’s legs free of spider veins.

Ideally you should seek for a phlebologist, someone with the experience and training to perform those procedures. In experienced hands you have the best chance for optimal results.

I am not aware of any reason why a person with Celiac disease needs to avoid sclerotherapy. The solutions are very safe, including one popular choice that is just salt water. These medications are all quickly cleared from the body. But ultimately that is something that needs to be discussed with the physician providing treatment.

There is no particular contraindication based on a skin tone. There might be an increased risk of matting in certain individuals with highly sensitive skin. Darker skin has a slightly higher risk of increased pigmentation [hyperpigmentation] after treatment with sclerotherapy. I am not aware of any study that says any particular area of the leg such as behind the knee that is particularly problematic.

Cosmetic sclerotherapy should not be done during pregnancy or breast feeding. It’s not worth taking any potential additional risks. With regards to facial spider veins, I prefer the Veinwave device to sclerotherapy!

Sclerotherapy is a common form of treatment for spider veins. It’s a simple in-office procedure where the veins are injected with a solution, using a tiny needle. This procedure can improve the cosmetic appearance and the associated symptoms as well. Depending on how many veins are involved the procedure usually takes 20-30 minutes. Keep in mind that a few sessions may be needed to obtain the maximum benefit. There can be some bruising right after sclerotherapy and the results of the treatment can take weeks or longer to be noticed.

After receiving Venus laser ablation with ultrasound-guided sclerotherapy I developed several large ulcers BELOW the knee area. Any explanation for what could have happened?

Ultrasound Guided Sclerotherapy can cause ulceration at the site of injection. This is a rare but a possible complication of any type of sclerotherapy. There are several possible mechanisms of ulcer formation. Two of the possible cause are as follows. Inadvertent injection of the sclerosing solution into the tissues around the vein can create the damage. More commonly is an essentially unavoidable potential for an injected vein to have a microscopic connection (fistula) with a small artery so that the vein solution gets shunted to the artery and causes an artery closure thereby damaging the skin fed by that small artery. When an unexpected event like this occurs the best approach is to speak with your provider. There are many causes of developing ulcers after your procedure some very simple and some not so simple. Your provider knows your exact history and procedure and will be able to provide you with the best care. I would encourage you to speak with him/her first.

Foam is created when a sclerosant is mixed with air or gas. Typically, room air is mixed with the solution to create the foam. This technique is very safe when done properly. The risk of any type of allergic reaction is due to the solution being used, not the air.

It depends on what type of vein is being treated: Bigger veins that are symptomatic might be covered by an insurance company; smaller asymptomatic spider veins generally are not. It also depends on the individual benefits of the insurance plan you have. Policies regarding vary depending on the insurance company. Finally, sometimes it depends on whether the sclerotherapy treatment is done as part of a larger treatment plan that includes treatment of the saphenous vein. Our experience has been that insurance does not cover any sclerotherapy unless it is completed following an endovenous laser procedure.

My doctor, during the screening, just said I had lots of veins and it would take at least 4 treatments. I specifically asked him about the ankle area and he just said “how afraid of needles are you?” I’ve read this area is difficult to treat?

Sclerotherapy can be very successful around the ankle. One must first be sure that all of the larger incompetent veins in the distal calf and ankle have been treated. I prefer to treat ankles in several sessions since overaggressive sclerotherapy at the ankle can result in temporary swelling of the foot which can be very annoying to patients. It is true however, that the foot and ankle are slightly more sensitive than the calf and thigh. These areas are basically skin and bone, with little subcutaneous tissue, or “meat” to help absorb inflammation. In addition, there are numerous tiny superficial nerves in these areas. Treatment is effective, but this area is sensitive.

Foam is just a way of agitating the sclerosant to make it “sudsy”. Ideally it is like shaving cream foam. It is the same drug used in standard ultrasound guided sclerotherapy. They are the same basic treatments just that the foam makes it stick to the vein better and therefore more effective.

No, the ultrasound is not harmful to the unborn fetus, although I would not recommend elective ultrasound guided injection sclerotherapy during pregnancy. I would reserve elective vein treatments during pregnancy only to injection of bleeding varicose or spider veins only after failure of conservative compression therapy.

I’ve heard a lot about sclerotherapy and how effective it is in treating cosmetic vein problems. What is the benefit of adding ultrasound technology to sclerotherapy? Is it worth the additional cost?

For spider veins that wouldn’t be necessary (nor feasible). Ultrasound guidance is used for bigger abnormal veins beneath the skin that are not visible. Ultrasound is also useful before treatment to uncover an underlying cause such as saphenous vein reflux. This is especially important if you have any symptoms of venous insufficiency: pain, swelling, aching, heaviness +/- varicose veins. One leading cause for treatment failure of spider veins is that there is an underlying leaking vein (which would be seen ultrasound). For larger veins it is often necessary to use ultrasound guidance to confirm the placement of the sclerosant and to help prevent complication.

Is there an added fee for the ultrasound technology when using ultrasound guided sclerofoam compared to regular foam sclerotherapy? Is the extra monitoring worth the extra trouble and possibly cost?

Ultrasound guided sclerotherapy (aka endovenous chemical ablation) is typically covered by insurance. This is performed to get rid of veins that are not visible to the naked eye or a special light (vein light). Ultrasound guidance is absolutely necessary for the procedure with would be dangerous without it. For the visible veins it is unnecessary.

It depends on what type of vein is being treated: bigger veins that are symptomatic might be covered by an insurance company and smaller asymptomatic spider veins generally are not. It also depends on the individual benefits of the insurance plan you have. Policies regarding vary depending on the insurance company. Finally, sometimes it depends on whether the sclerotherapy treatment is done as part of a larger treatment plan that includes treatment of the saphenous vein. Our experience has been that insurance does not cover any sclerotherapy unless it is completed following an endovenous laser procedure.

Depending on the type of vascular lesion, sclerotherapy could be an option. There are other non-surgical options as well for vascular lesions, such as laser treatment. Consultation with a vein specialist will help determine the most appropriate option for your situation.

While pregnant with my first child I’ve developed a large number of spider veins on my legs/thighs. Are spider veins more prevalent during pregnancy? Do they go away after delivery? Can I get sclerotherapy while I’m pregnant?

Sclerotherapy should be avoided during pregnancy. Spider veins may develop more rapidly during pregnancy and may subside some afterward though they usually will not disappear entirely. Wait until you and your baby are doing well and then see a phlebologist. Elastic support hose are a good idea during pregnancy to help keep up blood flow back to the heart from your legs.

Yes, but there are other options more commonly used.

If the chemical is injected directly into the vein and stops it up, couldn’t the blood clot and cause problems? Is sclerotherapy safe if someone has a blood clotting disorder?

The intention of sclerotherapy is to create inflammation within the lining of the vein, causing it to collapse and seal closed. This process frequently involves trapping and subsequent clotting of small amounts of blood within the involved vessel, which the body slowly reabsorbs over time. This process is perfectly normal, and is not dangerous. The dangerous types of blood clots are called “deep vein clots”, these vessels are all superficial, and very superficial, and involve small vessels. However, common sense would dictate that we would simply exercise more caution, and be more conservative with someone who has a known clotting disorder, depending on what type it is.

Foam sclerotherapy means combining the sclerotherapy medication with air to generate a foamed solution. This is then injected into the veins to promote absorption and resolution. Foam is generally used for the treatment of larger varicose veins that your doctor feels would be under treated with the sclerosing agent alone.

TI have both spider veins and varicose veins, and I was hoping to find a treatment that works on both. Is sclerotherapy effective for varicose veins?

Yes, sclerotherapy can be used to treat both varicose and spider veins. However, the most important issue in dealing with varicose veins is to make sure the underlying cause is treated in addition to the varicosities. An ultrasound is needed to see if there is a leaking vein and if so this should be ablated (closed down). Usually it is best to treat the underlying cause with either laser or radiofrequency ablation prior to performing sclerotherapy. Sclerotherapy may take several sessions to be effective.

There is a large vein on my face that doesn’t appear to be a broken capillary or spider vein. Could sclerotherapy be used to treat it, or would something else be better?

Sclerotherapy is an excellent treatment for large bluish veins that are usually on the temples. Sclerotherapy, however, is not very good at treating the fine reddish vessels in the center of the face.

Which chemicals are in the saline solution and does it have mercury in it and if not what is in it? what are the side effects if any.

The classic saline solution used for sclerotherapy was hypertonic saline, with no mercury or other additives. The problem with saline is that it burns tremendously, so it is no longer used by most. The current agents we use are called Sotradecol or Polidocanol, both of which have been used for many, many years with excellent results, and much less discomfort as compared to saline. There is no mercury in either compound, and the side effects are generally mild, and consist of bruising, mild tenderness, hyper pigmentation or mild discoloration, which slowly fades over time. The most significant potential, but rare, side effect could be a small surface skin ulcer, which usually heals very well over time.

In terms of functional recovery, such as the ability to continue on with your life there usually is no down time at all. You just put on your compression stockings and you are back to your your normal routines. The next question you might ask is when will is see results? This depends on the amount and strength of solution used, the types of veins being treated, your skin type, your genetic propensity to develop hyperpigmentation. You get the drift. It is different for everyone. The rule of thumb is about 6 weeks between large treatments and it could take many months before all of the pigment changes clear and everything fully heals.

Is foam sclerotherapy effective on the larger varicosities of the legs and should this type of procedure be guided by ultrasound? A vascular surgeon stated ultrasound guided foam sclerotherapy is safer than EVLT because of possible nerve damage.

In my 6 years’ experience of foam sclerotherapy, foam sclero is effective on small and larger varicose veins, provided it is administered correctly by targeting only the varicosity without causing damage to deep and healthy veins. Please note, the key is proper use of foam sclerotherapy which would be done under ultrasound guidance and based on detailed mapping of superficial veins system and reflux sources. In my opinion, the treating physician must have proper training and experience with sclerotherapy of varicose veins. Foam sclerotherapy has different side effects than an EVLT. Foam Sclerotherapy is less likely to cause nerve damage but has a very small risk of embolism to a distant part of the body which EVLT doesn’t have. Both EVLT and foam sclerotherapy have a low risk of complications. The choice between the two procedures should also be taken into consideration the effectiveness of the treatment and EVLT seldom has to be repeated whereas, foam sclerotherapy often has to be repeated. Your vein doctor will discuss the risk and benefits of any treatment with you prior to embarking on any treatment.

Is it bad for your health to have sclerotherapy? It seems dangerous to inject chemicals like that directly into the bloodstream. Couldn’t they spread and cause damage to other veins/areas of the body?

The known risk of toxicity from foam sclerotherapy is extremely low. The effects of sclerotherapy are generally quite localized to the treated veins and the communicating veins nearby. The injected solution is quickly diluted a few centimeters from the injection sites, and generally does not cause damage to other areas.

I am asked this question many times. You can safely get pregnant immediately after a treatment. But if you do get pregnant in the middle of a series of treatments, you should stop all treatments until 3 months after you deliver. This is a wide safety margin for the prevention of blood clots. The medications that are used by almost all experts, Sodium Tetradecyl Sulfate and Polidocanol, are very safe. They are fatty acid esters similar to lidocaine. They are cleared out of your system in 24 hours or less and present no difficulties.

The more you wait the better but the minimum is 6 weeks. You should wait for the acute inflammation to go away, usually in 4-6 weeks, depending on the solution used, the size of the vein treated and you skin complexion. (Olive skin or dark skin color may be more predisposed to darker discoloration than fair skin.) The main concern here is not to stimulate the melanin (skin pigment) producing skin cells and thus minimize the undesirable skin discoloration that may happen in the treated areas. A compromise may be to venture out with shorts and skirts with sunblock on at most, and certainly no sun tanning. In time, you may resume normal activities with normal sun exposure.

I am scheduled for an MRI with contrast (by injection) for a hamstring tear and lesion, this will be done 10 days after I have Asclera Sclerotherapy injections in the same leg (thigh and calf). Is there any conflict with these 2 treatments & agents?

You can safely have an MRI with contrast 10 days after foam sclerotherapy.

My doctor uses the Vbeam for my spider veins but it doesn’t work and causes bruising. Is it the right type of laser?

The V Beam uses a wavelength of 595 nm which can certainly treat spider veins. However, these lasers seem to work best on facial veins and on leg veins. Treatment of leg veins with lasers in general has been disappointing. Sclerotherapy is still considered the gold standard. Newer sclerosants offer significant improvement over hypertonic saline.

I had 3 sclera sessions over 5 weeks. After the 3rd one, the saph vein in the lower leg was accidentally blocked. Now I am getting a large indentation, just above the ankle where the sock is. Why the swelling? Should saph vein be treated?

It is difficult to answer this question without more information. At the very least, you should have a venous ultrasound to evaluate the saphenous veins and the deep system. If these are OK, then the swelling is most likely just due to the sclerotherapy and should resolve with time. If the deep veins are normal, then compression stockings may help.

I had sclerotherapy on the backs of my hands. A few weeks after I got a really bad eye infection in both of my eyes that I have had for about 3 months and still have. Could it be related? Can the solution travel to my eyes? Thanks!

No, sclerotherapy cannot cause eye infections.